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NPI Code Detail

MEDICARE: VICTOR D CHIAROLLA RPH

MEDICARE: VICTOR D CHIAROLLA RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH26746CA

General Provider Information

NPI Number : 1396027454
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR D CHIAROLLA RPH
Provider Business Mailing Address
First Line : 79 COTTONWOOD DR
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-1448
Country : US
Telephone Number : 415-256-9396
Fax Number :
Provider Business Practice Location Address
First Line : 830 3RD ST
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-3302
Country : US
Telephone Number : 415-455-9919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2011
Last Update Date : 09/15/2011

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Directions to “ VICTOR D CHIAROLLA RPH” Practice Location

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